At Sierra Dental, we emphasize that dental care is an essential part of overall health. Learn how oral health and body health are related. Unfortunately, many Canadians still struggle to receive proper care. And this is usually because of the cost of dental treatments.
This is where the Canada Dental Care Plan (CDCP) can make a difference.
The Canada Dental Care Plan (CDCP) is one of the country’s largest social programs. It is a government initiative that is designed to improve access to dental care for Canadians who are unable to afford it. The plan coverage includes a wide range of procedures that can improve and maintain oral health.
Sierra Dental is proud to be among the over 25,000 participating providers across Canada, ready to welcome and care for Calgary families who are eligible under the CDCP. If you want to learn more about the CDCP, what it is, who is eligible, and how to apply, read along this comprehensive guide.
What is the Canada Dental Care Plan (CDCP)?
Did you know that almost one in four Canadians avoid dental care due to cost? This is the main reason why the Canada Dental Care Plan (CDCP) was introduced. The goal is to make essential and emergency dental care more accessible to low-income families.
This initiative is a major step toward reducing dental-health related disparities. The CDCP ensures that all Canadians, no matter their socioeconomic status, can receive the dental care they need.
Canada Dental Care Plan (CDCP): How It Differs From Other Programs
You might wonder how the CDCP compares to other existing local provincial dental programs in Calgary or private insurance. Some key difference include:
Broad, income-based eligibility
Many provincial programs are limited to specific age brackets. Meanwhile, the CDCP is focused on helping low- to middle-income individuals and families.
Comprehensive coverage
The CDCP covers more than just basic dental procedures. It extends to even emergency and preventive treatments for a more complete care.
No monthly premiums
Unlike private insurances that need monthly payments to renew and extend your plan, the CDCP promises no out-of-pocket monthly to maintain coverage.
Our commitment to Calgary families goes beyond exceptional dental care. As a CDCP provider, we follow their set standards and policies to ensure all eligible patients receive complete coverage.
Eligibility Criteria for the Canada Dental Care Plan (CDCP)
To qualify for the Canada Dental Care Plan, you must meet certain eligibility criteria. Here is a detailed breakdown to help our Calgary patients determine if they can be covered:
- Age requirements – The CDCP is designed to cover all ages. But, children under 18 and senior patients (65+) are prioritized. This may change in the future.
- Income threshold – Canadian families with an annual household income of less than $90,000 are eligible.
- Lack of alternative coverage – You must not have access to other dental insurance plans, including employment benefits, other health and wellness accounts, from professional or student organizations, pension benefits, and individual or group coverage from companies.
- Updated tax returns – You and your spouse/common-law-partner must have filed your annual tax returns for assessment.
- Residency – You must be a Canadian resident for tax purposes.
To find out if you qualify, you can use the online eligibility checker provided in the official CDCP website. It should provide a checklist and upon confirmation, it will redirect you to your designated application schedule according to your age group.
| Adjusted family net income | How much will the CDCP cover | How much will you cover |
|---|---|---|
| Lower than $70,000 | 100% of eligible oral health care service costs will be covered at the CDCP established fees | 0% of the CDCP established fees |
| Between $70,000 and $79,999 | 60% of eligible oral health care service costs will be covered at the CDCP established fees | 40% co-payment under the CDCP established fees |
| Between $80,000 and $89,999 | 40% of eligible oral health care service costs will be covered at the CDCP established fees | 60% co-payment under the CDCP established fees |
At Sierra Dental, we remain transparent about our pricing so our patients, including our CDCP-covered families, know how much of their treatment is covered and how much they will need to personally shell out.
About Additional Charges
Calgary patients under the CDCP coverage may still face additional charges in addition to the rules of co-payment if:
- The cost of the treatment provided is more than what the established CDCP fees are
- You agree to receive dental care that the plan does not cover
Before you begin treatment, it is important that we do an initial consultation, not just to discuss your treatment plan, but also to inform you of the costs that will not be covered by the CDCP. This will help you prepare to cover the additional expenses, if necessary.
How to Compute for Co-payment and Additionals
If you are confused about the cost of your dental treatment under the CDCP, considering co-payment and additional charges, here is an example we can apply in our Calgary clinic:
- An individual under 40% co-payment to undergo 2 units of scaling
- CDCP fee: $134, oral health practitioner’s fee: $145
In this scenario, the patient is required to pay the difference of $11 and the 40% co-payment which is $53.60. So, they will pay the team a total of $64.60, while the CDCP will cover the rest.
Pre-authorization
Pre-authorization is a process to request coverage for dental services before treatment. Certain dental services, though covered by the CDCP, require pre-authorization so both the patient and oral health provider can understand if the treatment is covered and the limitations, if there are any.
Pre-authorization is required for:
- Root canal retreatment
- Bonding of mobile teeth
- Post-surgical evaluations
- Crowns, posts, and cores
- Complete immediate and overdentures
- Partial dentures
- Moderate and deep sedation
- General anesthesia
If your treatment requires a pre-authorization, we will send this request along with other supporting requirements to assist with completing your treatment coverage. Decisions, depending on the nature of service, are valid for up to 24 months from approval. This is provided that you are still covered by the plan on the date of treatment.
Frequency Limitations
This refers to the restrictions on how often certain dental services can be covered by the CDCP within a specific time period. It takes into accounts all the treatments under the CDCP.
To know more about the limitations, you may access this link. It also includes services that require pre-authorization, those out of coverage at any time, and corresponding frequency limitations on specific treatments.
Tips to Ensure a Smooth Application Process
Many of our Calgary patients have benefited from the CDCP. To avoid denied applications, here are a few tips we can share to you:
- Double check your information – Ensure that all details are up-to-date, accurate, and complete before submitting.
- Gather all documents – Missing paperwork can cause application delay and denial.
- Submit online if possible – Digital submissions are processed quicker than other application options.
- Do not resend applications – Wait for your plan decision patiently and avoid resending. You may check the online status checker for updates.
How to Find a Participating Dentist or Clinic
Sierra Dental is proud to be a participating clinic in the Canada Dental Care Plan (CDCP). If you are within Calgary or surrounding areas and would like to maximize your coverage plan, simply schedule an appointment with us via (403) 297-9600 and we will go over your benefits, discuss your options, and help you with treatment.
If you are looking for other participating providers, here’s how you can find them:
- Online directory – A list of CDCP oral health providers is available through the Sun Life website. You may access it here.
- Contact Sun Life – You may also directly call the Sun Life CDCP Contact Centre at 1-888-888-8110 for more information.
- Referrals – Your local dentist in Calgary, another healthcare professional, or someone you know may also provide information on participating clinics or dentists.
